| Steve Pethick, Phd Pc | |
|
401 E 10th Ave Ste 530 Eugene OR 97401-3367 | |
| (541) 687-7787 | |
| (855) 646-7433 |
| Full Name | Steve Pethick, Phd Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 401 E 10th Ave Ste 530, Eugene, Oregon |
| Authorized Official Name and Position | Stephen Pethick (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5416877787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steve Pethick, Phd Pc Po Box 3163 Eugene OR 97403-0163 Ph: (541) 687-7787 | Steve Pethick, Phd Pc 401 E 10th Ave Ste 530 Eugene OR 97401-3367 Ph: (541) 687-7787 |
| NPI Number | 1013322411 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 03/29/2021 |
| Certification Date | 03/05/2021 |
| Medicare PECOS PAC ID | 5799190815 |
|---|---|
| Medicare Enrollment ID | O20210405002200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013322411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1569 (Oregon) | Primary |
| Provider Name | Stephen J Pethick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356404172 PECOS PAC ID: 4880678747 Enrollment ID: I20040617000230 |
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